M. Sharpley et al., Understanding the excess of psychosis among the African-Caribbean population in England - Review of current hypotheses, BR J PSYCHI, 178, 2001, pp. S60-S68
Background Increased rates of schizophrenia continue to be reported among t
he African-Caribbean population in England.
Aims To evaluate the competing biological, psychological and social explana
tions that have been proposed.
Method Literature review.
Results The African-Caribbean population in England is at increased risk of
both schizophrenia and mania; the higher rates remain when operational dia
gnostic criteria are used. The excess of the two psychotic disorders are pr
obably linked: African-Caribbean patients with schizophrenia show more affe
ctive symptoms, and a more relapsing course with greater social disruption
but fewer chronic negative symptoms, than White patients. No simple hypothe
sis explains these findings.
Conclusions More complex hypotheses are needed. One such links cultural var
iation in symptom reporting, the use of phenomenological constructs by psyc
hiatrists and social disadvantage.
Declaration of interest None.